Letters going out to patients who received wrong prostate test
Stars and Stripes September 20, 2013
KAISERSLAUTERN, Germany — The Army’s top medical command in Europe is sending notifications to more than 3,200 patients who received incorrect prostate cancer tests between August 2009 and May 2012.
Patients affected by the error, which occurred at medical facilities in Germany, Italy, Belgium, Kosovo and the U.S. Central Command area of responsibility supported by Landstuhl Regional Medical Center’s laboratory, have been identified and should receive a letter in the next seven to 10 days informing them of the mistake, according to Europe Regional Medical Command.
There are two tests available to detect prostate-specific antigen, or PSA, a chemical that is elevated in cases of prostate disease or prostate trauma and has historically been used as a screening test for prostate cancer, said Col. Thomas Frank, chief of the division of medicine at LRMC.
“One is the Total PSA’ which is used for screening, and the other is a‘Free PSA’ which is not used for screening, but used by urologists if the PSA is elevated.”
For about 3,280 patients, “the Free PSA was erroneously ordered in lieu of the screening test. So those patients who received the Free PSA without the Total PSA were not truly screened for prostate cancer,” Frank said.
The Free PSA test was added to a medical database in 2009, and appeared in a menu of tests above the more common Total PSA test, Frank said.
In May 2012, “a few providers noticed they had patients coming back with Free PSAs but no Total PSA tests. They recognized the problem in the computer menu and immediately rectified it,” Frank said.
“At the time they did that, they didn’t realize” how long it had been going on or the scope of the problem. When a patient reported to a patient advocate that he’d been given the wrong test, LRMC staff analyzed their database to learn the full extent of the problem and identify those affected, Frank said.
Screening guidelines for PSA are in evolution, Frank said, and have changed since some patients were given the incorrect test.
“So what we are recommending is that every patient who had this Free PSA drawn have a discussion with his primary care provider to determine what the most appropriate next step is for the patient.”